The "last frontier" in back surgery
Dr. Salame |
Backus Hospital has begun offering patients a less invasive spinal surgery, the XLIF procedure, for the lower back that is done through the side rather than the front or back.
"It is different from other procedures because of the way we approach the spine," said Camille G. Salame, MD, a neurosurgeon and spine surgeon on the Backus Medical Staff with a private practice in Norwich. "There is extremely minimal blood loss and minimal pain the day after the surgery. It is very clean and simple."
Dr. Salame began performing the surgeries in November 2006. He said it has become more popular on the West Coast, but Backus is one of the few hospitals in New England to offer it.
Dr. Salame said when spinal fusion surgery is done traditionally, it is done either from the front or the back. Either way more muscles are affected, and anatomy impacts how parts of the lower spine can be repaired. Also, he said screws and rods are needed, because the spine is destabilized. Often with this type of surgery, screws and rods aren't necessary.
"I really believe this is the last frontier in lower back spine fusion," Dr. Salame said.
It is an option for patients who have degenerative disc disease or scoliosis and can be used as a rescue procedure if another type of spinal procedure fails.
According to the National Institutes of Health, at some point, back pain affects an estimated 8 out of 10 people.
Anne Marie Canova, 64, of Bozrah had the surgery in late November.
Along with degenerative disc disease, she had been in a car accident about five years ago that had contributed to her back pain.
"I just thought it was pain I was going to have to live with, but when I went in to see an orthopedic surgeon about pain in my hip, he said my back was impacting that as well," she said. So after being treated for bursitis, she saw Dr. Salame and learned she needed further treatment. In the past, he had repaired her herniated discs.
"He is my hero. He is such a brilliant man," she said.
She said after the surgery, she has no pain in her back, but there was pain from the healing of the surgical site and a groin muscle.
"I think the healing of that muscle was the worst part," Ms. Canova said. "It is three months after the surgery and I have more range of motion than I have for the last five years. I can bend over and I couldn't before."
She said it was about two months before she could go back to work as a part-time HIV counselor.
With the front or back traditional incisions, she would have lost more blood during the surgery. "There were just two incisions on my side, one was about four inches and the other was three, no sutures or staples, they just used a steri-strip," she said.
"I have done five patients so far with this type and no screws or rods have been needed," Dr. Salame said. Out of the five patients, he has repaired eight discs, because some had problems with more than one disc.
"Most of my patients have been in their 60s and 70s," he said. "It is well tolerated by the older population as well as younger patients."
All of his patients so far have had degenerative disc disease.